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Atmaca M. Selective Serotonin Reuptake Inhibitor-Induced Sexual Dysfunction: Current Management Perspectives. Neuropsychiatr Dis Treat 2020; 16:1043-1050. [PMID: 32368066 PMCID: PMC7182464 DOI: 10.2147/ndt.s185757] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 04/07/2020] [Indexed: 12/30/2022] Open
Abstract
Any type of sexual dysfunction is an important problem in half of the patients with depressive disorder. On the other hand, one to a quarter of people without any depressive disorder experience sexual dysfunction. Antidepressant agents can lead to all types of sexual side effects including arousal, libido, orgasm and ejaculation problems. Selective serotonin reuptake inhibitors (SSRIs) are a widely used class of drugs which are prescribed for the treatment of a variety of disorders, including major depressive disorder, obsessive-compulsive disorder, posttraumatic stress disorder, panic disorder, generalized anxiety disorder, and impulse control disorders. It has been reported that one in eight people have utilized one of the SSRIs in the past 10 years. Some studies reported up to 80% of SSRI-induced sexual side effects. Management of SSRI-induced sexual dysfunction seems to be complex and hard. In this paper, SSRI-induced sexual dysfunction and new perspectives in the management of this problem were reviewed.
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Affiliation(s)
- Murad Atmaca
- Department of Psychiatry, Firat University School of Medicine, Elazig, Turkey
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2
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O'Mullan C, Debattista J, Parkinson L. "I'm in control: I'm not stumbling in the dark anymore": Midlife women's experiences of successfully negotiating safer sex with new partners. J Women Aging 2018; 31:73-88. [PMID: 30160639 DOI: 10.1080/08952841.2018.1510243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The rates of STIs in women over 45 years have been steadily increasing in Australia and other Western countries. Traditionally sexual health and STI prevention and research has positioned young people as the priority population; to date, insufficient attention has been paid to the sexual health of women over 45 years. Using a strengths-based approach, the objective of this study was to explore the factors and mechanisms that enable Australian women aged 45 to 64 years to successfully negotiate safer sex practices in new relationships. Interpretative Phenomenological Analysis (IPA) was employed for an in-depth exploratory study of a sample of eight women. Three broad themes emerged: being informed, being prepared, and being empowered. These findings provide a valuable insight into how we can initiate change and support safer sex practices for this target group.
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Affiliation(s)
- Cathy O'Mullan
- a School of Health, Medical and Applied Science , Central Queensland University , Rockhampton , Australia
| | - Joseph Debattista
- b Metro North Public Health Unit , Queensland Health , Brisbane , Australia
| | - Lynne Parkinson
- a School of Health, Medical and Applied Science , Central Queensland University , Rockhampton , Australia
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Chokka PR, Hankey JR. Assessment and management of sexual dysfunction in the context of depression. Ther Adv Psychopharmacol 2018; 8:13-23. [PMID: 29344340 PMCID: PMC5761906 DOI: 10.1177/2045125317720642] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/22/2017] [Indexed: 12/19/2022] Open
Abstract
Sexual dysfunction (SD) is pervasive and underreported, and its effects on quality of life are underestimated. Due in part to its bidirectional relationship with depression, SD can be difficult to diagnose; it is also a common side effect of many antidepressants, leading to treatment noncompliance. While physicians often count on patients to spontaneously report SD, treatment is optimized when the clinician instead performs a thorough assessment of sexual functioning before and during drug therapy using a standardized questionnaire such as the Arizona Sexual Experiences Scale (ASEX). Separating the effects of the disorder from those of medications is challenging; we present a concise, evidence-based schematic to assist physicians in minimizing treatment-emergent sexual dysfunction (TESD) while treating depression. Vascular, hormonal, neurogenic, and pharmacological factors should be considered when a patient presents with SD. We also recommend that physicians obtain patient information about baseline and historical sexual functioning before prescribing a drug that may lead to SD and follow up accordingly. When the goal is to treat depression while attenuating the risk of sexual symptoms, physicians may wish to consider agomelatine, bupropion, desvenlafaxine, moclobemide, trazodone, vilazodone, and vortioxetine.
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O'Mullan C, Doherty M, Coates R, Tilley PJM. Using Interpretative Phenomenological Analysis (IPA) to provide insight into female sexual difficulties. SEXUAL AND RELATIONSHIP THERAPY 2017. [DOI: 10.1080/14681994.2017.1386300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Cathy O'Mullan
- School of Medical, Health & Applied Sciences, Central Queensland University, Bundaberg, Queensland, Australia
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Maryanne Doherty
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Rosemary Coates
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - P. J. Matt Tilley
- School of Public Health, Curtin University, Perth, Western Australia, Australia
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Francois D, Levin AM, Kutscher EJ, Asemota B. Antidepressant-Induced Sexual Side Effects: Incidence, Assessment, Clinical Implications, and Management. Psychiatr Ann 2017. [DOI: 10.3928/00485713-20170201-01] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Winch CJ, Sherman KA, Smith KM, Koelmeyer LA, Mackie H, Boyages J. "You're naked, you're vulnerable": Sexual well-being and body image of women with lower limb lymphedema. Body Image 2016; 18:123-34. [PMID: 27434105 DOI: 10.1016/j.bodyim.2016.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 06/06/2016] [Accepted: 06/07/2016] [Indexed: 12/26/2022]
Abstract
Lower-limb lymphedema is an incurable illness manifesting as visible swelling enlarging the leg(s) and/or feet, buttocks, and genitals. This study used semi-structured interviews and thematic analysis to explore sexual well-being among women with primary (congenital) lymphedema (n=11) or secondary lymphedema associated with gynecological cancer (n=8). Five themes (subthemes) summarized women's responses, with Attractiveness and Confidence (Publicly Unattractive, Privately Unconfident, Lymphedema or Aging?) describing women's central concern. These body image-related concerns accounted for sexual well-being in association with Partner Support (Availability of Support, Languages of Support, Fears About Support) and the degree of Functional Interruptions (Lymphedema in Context, Enduring Impacts, Overcoming Interruptions). Successful Lymphedema Coping (Control, Acceptance) and self-perceived ability to fulfill a valued Sexual Role also affected sexual well-being. Few differences between women with primary versus secondary lymphedema were evident. Lymphedema clinicians should screen for sexual concerns and have referral options available.
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Affiliation(s)
- Caleb J Winch
- Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Kerry A Sherman
- Centre for Emotional Health, Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, New South Wales, Australia.
| | - Katriona M Smith
- Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Louise A Koelmeyer
- Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Helen Mackie
- Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia; Mt. Wilga Private Hospital, Sydney, New South Wales, Australia
| | - John Boyages
- Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
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Gibson K, Cartwright C, Read J. Conflict in Men's Experiences With Antidepressants. Am J Mens Health 2016; 12:104-116. [PMID: 26993998 DOI: 10.1177/1557988316637645] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
While men's experiences of depression and help seeking are known to be shaped by gender, there is little research which examines their experience of using antidepressants to treat this. This study is based on in-depth, narrative-style interviews with 20 New Zealand men who had used antidepressants. The analysis identified a number of areas of conflict in the men's accounts of using this medication. Conflict centered on the way taking antidepressants was seen as undermining personal control while also allowing users to take charge of their problems; facilitating general functioning while undermining sexual functioning; relieving emotional distress while undermining emotional vitality; and the tension participants felt between making autonomous judgments about the value of antidepressants and relying on the "expertise" of others. Participants negotiated these conflicts in a variety of ways. In some cases, antidepressants were positioned as being able to affirm aspects of traditional masculinity, while a smaller number of participants managed these conflicts by redefining aspects of their own masculinity in ways that contrasted with dominant constructions. This research is limited by the sample of older, more privileged men in the context of New Zealand culture which favors macho forms of masculinity. In similar contexts, mental health practitioners should be mindful of the conflicts that men might experience in relation to their antidepressant use. Facilitating men's exploration of these issues may enable them to make better decisions about treatment options or to provide more effective support to those who have opted for antidepressant treatment.
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Affiliation(s)
| | | | - John Read
- 2 Swinburne University of Technology, Melbourne, Victoria, Australia
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O'Mullan C, Doherty M, Coates R, Tilley PM. ‘Accepting what is’: an approach for managing the long-term sexual side effects of selective serotonin reuptake inhibitors (SSRIs) in women. SEXUAL AND RELATIONSHIP THERAPY 2015. [DOI: 10.1080/14681994.2015.1032236] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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